Individual
JONATHAN R MALOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4123 DUTCHMANS LANE SUITE 301, SUBURBAN MEDICAL PLAZA 3, LOUISVILLE, KY 40207
(502) 896-2500
(502) 896-2527
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
236963
MA
208000000X
Pediatrics Physician
47264
KY
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
47264
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000881354
ANTHEM-KCNS
KY
01
—
1033371216
PASSPORT-KCNS
KY
01
—
163566
SIHO-KCNS
KY
05
—
7100309620
—
KY
Enumeration date
06/27/2008
Last updated
04/22/2025
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